Neurath M F, Hildner K, Becker C, Schlaak J F, Barbulescu K, Germann T, Schmitt E, Schirmacher P, Haralambous S, Pasparakis M, Meyer Zum Büschenfelde K H, Kollias G, Märker-Hermann E
Laboratory of Immunology, I Medical Clinic, University of Mainz, Germany.
Clin Exp Immunol. 1999 Jan;115(1):42-55. doi: 10.1046/j.1365-2249.1999.00753.x.
Immunosuppressive therapy with methotrexate (MTX) has been established as effective treatment for patients with rheumatoid arthritis. To analyse the therapeutic potential and mechanisms of action of MTX, we determined serum cytokine levels and cytokine production by splenic T cells and macrophages in untreated and MTX-treated mice. Furthermore, we assessed the role of MTX in a murine model of experimental arthritis induced by collagen type II (CIA). MTX reduced spontaneous and IL-15-induced tumour necrosis factor (TNF) production by splenic T cells but not by macrophages from healthy mice in vitro in a dose-dependent manner. In contrast, interferon-gamma (IFN-gamma) production was less strikingly reduced and IL-4 production was virtually unaffected. In addition, treatment of healthy mice with MTX in vivo led to reduced TNF serum levels and diminished TNF production by splenic T cells and macrophages. Intraperitoneal administration of MTX prior to the onset of arthritis completely prevented clinical and pathological signs of CIA. This was associated with a striking reduction of TNF production by spleen cells from MTX-treated mice. The role of TNF in MTX-mediated effects on cytokine production was further underlined by the finding that MTX effects on IFN-gamma production were augmented in TNF-transgenic mice but abrogated in mice in which the TNF-alpha gene had been inactivated by homologous recombination. Thus, MTX specifically modulates spontaneous and IL-15-induced TNF-alpha production in mice and prevents experimental murine CIA. These data suggest that TNF production by T cells is an important target of MTX and may serve as a basis to understand and further analyse MTX-mediated mechanisms of immunosuppression in patients with RA.
甲氨蝶呤(MTX)免疫抑制疗法已被确立为类风湿性关节炎患者的有效治疗方法。为了分析MTX的治疗潜力和作用机制,我们测定了未治疗和MTX治疗小鼠的血清细胞因子水平以及脾T细胞和巨噬细胞产生细胞因子的情况。此外,我们评估了MTX在II型胶原诱导的实验性关节炎小鼠模型中的作用。MTX在体外以剂量依赖的方式降低了健康小鼠脾T细胞自发产生的以及IL-15诱导产生的肿瘤坏死因子(TNF),但对巨噬细胞产生的TNF没有影响。相比之下,干扰素-γ(IFN-γ)的产生减少不太明显,而IL-4的产生几乎不受影响。此外,在体内用MTX治疗健康小鼠导致TNF血清水平降低,脾T细胞和巨噬细胞产生的TNF减少。在关节炎发作前腹腔注射MTX完全预防了II型胶原诱导的关节炎(CIA)的临床和病理体征。这与MTX治疗小鼠脾细胞产生的TNF显著减少有关。MTX对IFN-γ产生的影响在TNF转基因小鼠中增强,但在通过同源重组使TNF-α基因失活的小鼠中被消除,这一发现进一步强调了TNF在MTX介导的细胞因子产生效应中的作用。因此,MTX特异性调节小鼠自发产生的以及IL-15诱导产生的TNF-α,并预防实验性小鼠CIA。这些数据表明,T细胞产生的TNF是MTX的重要靶点,可能为理解和进一步分析MTX介导的类风湿性关节炎患者免疫抑制机制提供基础。